title: Short-term and intermediate-term results after unclipping: what happened to primary hyperhidrosis and truncal reflex sweating after unclipping in patients who underwent endoscopic thoracic sympathetic clamping?
abstract: Endoscopic thoracic sympathetic clamping (ETC) is used to treat patients with primary hyperhidrosis because it offers the potential of a reversal operation (unclipping) when severe reflex sweating (RS) occurs. Although unclipping has been reported to be effective, the short-term or intermediate-term results after unclipping are unclear. From March 2002 to October 2006, 15 (12.9%) out of 116 patients with primary hyperhidrosis, who underwent ETC, had the endoclip(s) removed as a result of RS. Fourteen patients could be followed up for more than 6 months. The patients answered a telephone interview on the severity of RS, the recurrence of the primary site, and their level of satisfaction. There was no mortality or significant morbidity encountered. On the follow-up, 9 (64%) of the 14 patients who underwent unclipping reported symptomatic recovery from RS. Of these 9 patients with early unclipping (within 4 wk after ETC), only 7 (78%) were satisfied with the outcomes. This suggests that early unclipping does not always guarantee satisfactory recovery from RS. Because early unclipping does not guarantee a full recovery in all patients, special consideration in ETC is needed to determine when to remove the clamp and how strongly to apply the clamp to achieve better results.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Kangnam St Mary Hospital, Seoul, Republic of Korea.
authors.forename: Cheol Woong
authors.initials: CW
authors.lastname: Kang
authors.forename: Si Young
authors.initials: SY
authors.lastname: Choi
authors.forename: Seok Whan
authors.initials: SW
authors.lastname: Moon
authors.forename: Deog Gon
authors.initials: DG
authors.lastname: Cho
authors.forename: Jong Beom
authors.initials: JB
authors.lastname: Kwon
authors.forename: Sung Bo
authors.initials: SB
authors.lastname: Sim
authors.forename: Young Pil
authors.initials: YP
authors.lastname: Wang
authors.forename: Keon Hyeon
authors.initials: KH
authors.lastname: Jo
mesh_terms: D000293:Adolescent; D000328:Adult; D006801:Humans; D006945:Hyperhidrosis / Q000503:physiopathology / Q000601:surgery*; D008875:Middle Aged; D012008:Recurrence; D012018:Reflex; D013525:Surgical Instruments; D013546:Sweating; D013562:Sympathectomy / Q000379:methods; D013906:Thoracoscopy; D055815:Young Adult